Fig 1.
Overview of the RUQ telediagnostic ultrasound system.
Imaging information of the right upper abdominal quadrant is acquired by health personnel of any skill level and is sent through the tablet from the health center for remote imaging interpretation (blue arrows). A diagnostic report is returned to the health center for the health personnel and patient (green arrows).
Fig 2.
The RUQ protocol involves 6 sweeps each beginning and ending with an arc of the probe that has not been illustrated for simplicity. An arc consists of a fan-like motion of the probe (shown in S1 File). The arcing of the probe allows maximal visualization. Steps a-c involve transverse sweeps of the probe in the supine position. Steps d and e are conducted in the left lateral decubitus position. Step f is performed in the standing position. The patient takes a deep breath during each step.
Table 1.
Image quality and organ visualization of all examinations.
Table 2.
Agreement between VSI and standard of care for acceptable/excellent image quality.
Table 3.
Sensitivity/Specificity for cholelithiasis.
Fig 3.
(a) Normal liver identified on transverse VSI scan. (b) Normal gallbladder (arrows) identified on sagittal VSI scan. Transverse (c) and sagittal (d) images of the kidney (arrows) with partial visualization of the liver (*). S2 File includes the cine clips of this exam.
Fig 4.
Cholelithiasis with echogenic stone and posterior acoustic shadowing seen on standard of care (a) and VSI (b). Online Video 3 includes a sample cine clip of this study.
Fig 5.
Gallbladder polyp with faint comet tail artifact seen on standard of care (a) and VSI (b).
Fig 6.
Diffuse hepatic steatosis seen on standard of care imaging (a) and VSI (b). In both images there is significant increase in hepatic echogenicity.